Dignity Transcends

Leslie was the kind of person who made both men and women's heads turn as she walked down the hallway. Her back arched forward with perfect posture as she waited for me to enter the exam room. She stood, using one hand she parted the blond curls that fell in front of her face, and extended the other towards me in greeting.

I sat comfortably at the desk and opened my computer in preparation to start the physical. Leslie swayed back and forth in her chair slowly, and I sensed that something was bothering her.

Because she was a new patient, we chatted about her current health and past medical problems. I asked gentle probing questions to tease out the source of her discomfort. Although I had finished all the requisite social and family history, I still found myself searching

I opened the cabinet above the desk and pulled out a gown in preparation for the physical exam. At the sight of the white flimsy covering, Leslie's face became a bright shade of pink, and she turned in embarrassment. I was surprised by this kind of reaction from such a strong, confident appearing woman.

Is something wrong?

Leslie turn to face me again, and paused as she mentally rehearsed the next sentence.

You see Dr Grumet...I thought you were a woman....and I didn't shave my...

Her words trailed off as we both started to laugh. I offered her an appointment with my female partner, but instead she decided to return and finish the exam the next week when she was better prepared for the visit.

I sat in my office and giggled as I looked out the window and watched Leslie gracefully lower herself into the driver seat of her car.

And then I remembered something.

*

The morning rhythm of the ICU greeted my ears as I walked through the doors. The sound of shuffling feet, blowing ventilators, and beeping machines formed a raucous chorus. I stopped at the computer bank and looked at my patients labs and vitals.

She was much to young to be in this setting. Her twenty five year old body was stronger and more resilient then the average ICU patient. But the effects of chemo had taken their tole. Her immune system damaged and short handed, couldn't fight off the bacteria that plunged into her respiratory system.

Things were looking up. The chemo had finished. The ventilator was removed and life was beginning again. A bed was ready in the step down unit and hopefully she would go home soon. We chatted for a few moments before I started my examination. The lungs were clear; the heart was normal.

As I went to examine the legs for edema, my patient threw back her covers to reveal newly manicured toes with a bold shade of red polish. I looked up to the head of the bed to see her smiling.

She had been waiting all morning to spring this on me.

*

It becomes very easy in medicine to shun vanity. We looked past the dirty, unkempt, disease ridden bodies of our patients as a matter of course. We somehow picture ourselves too much above the fray to stoop to such banality.

But one thing I've learned from my patients is that dignity transcends sickness and health. That caught in the middle of a health care system that focuses on depersonalization, it takes courage to maintain ownership.

These women were trying to remind me that they are not just patients.

They are people: flawed, vain, courageous, and awe inspiring.